TY - JOUR
T1 - Outcomes of human leukocyte antigen-matched sibling donor hematopoietic cell transplantation in chronic lymphocytic leukemia
T2 - Myeloablative versus reduced-intensity conditioning regimens
AU - Sobecks, Ronald M.
AU - Leis, Jose F.
AU - Gale, Robert Peter
AU - Ahn, Kwang Woo
AU - Zhu, Xiaochun
AU - Sabloff, Mitchell
AU - de Lima, Marcos
AU - Brown, Jennifer R.
AU - Inamoto, Yoshihiro
AU - Hale, Gregory A.
AU - Aljurf, Mahmoud D.
AU - Kamble, Rammurti T.
AU - Hsu, Jack W.
AU - Pavletic, Steven Z.
AU - Wirk, Baldeep
AU - Seftel, Matthew D.
AU - Lewis, Ian D.
AU - Alyea, Edwin P.
AU - Cortes, Jorge
AU - Kalaycio, Matt E.
AU - Maziarz, Richard T.
AU - Saber, Wael
N1 - Funding Information:
The CIBMTR is supported by Public Health Service Grant /Cooperative Agreement U24-CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); a Grant/Cooperative Agreement 5U10HL069294 from NHLBI and NCI ; a contract HHSH250201200016C with Health Resources and Services Administration (HRSA/DHHS); two Grants N00014-12-1-0142 and N00014-13-1-0039 from the Office of Naval Research ; and grants from * Actinium Pharmaceuticals ; Allos Therapeutics, Inc. ; * Amgen, Inc. ; Anonymous donation to the Medical College of Wisconsin ; Ariad ; Be the Match Foundation ; * Blue Cross and Blue Shield Association ; * Celgene Corporation ; Chimerix, Inc. ; Fred Hutchinson Cancer Research Center ; Fresenius-Biotech North America, Inc. ; * Gamida Cell Teva Joint Venture Ltd. ; Genentech, Inc. ; * Gentium SpA ; Genzyme Corporation ; GlaxoSmithKline ; Health Research, Inc. Roswell Park Cancer Institute ; HistoGenetics, Inc. ; Incyte Corporation ; Jeff Gordon Children's Foundation ; Kiadis Pharma ; The Leukemia & Lymphoma Society ; Medac GmbH ; The Medical College of Wisconsin ; Merck & Co, Inc. ; Millennium: The Takeda Oncology Co. ; * Milliman USA, Inc. ; * Miltenyi Biotec, Inc. ; National Marrow Donor Program ; Onyx Pharmaceuticals ; Optum Healthcare Solutions, Inc. ; Osiris Therapeutics, Inc. ; Otsuka America Pharmaceutical, Inc. ; Perkin Elmer, Inc. ; * Remedy Informatics ; * Sanofi US ; Seattle Genetics ; Sigma-Tau Pharmaceuticals ; Soligenix, Inc. ; St. Baldrick's Foundation ; StemCyte, A Global Cord Blood Therapeutics Co. ; Stemsoft Software, Inc. ; Swedish Orphan Biovitrum ; * Tarix Pharmaceuticals ; * TerumoBCT ; * Teva Neuroscience, Inc. ; * THERAKOS, Inc. ; University of Minnesota ; University of Utah ; and * Wellpoint, Inc. The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government.
PY - 2014/9
Y1 - 2014/9
N2 - Allogeneic hematopoietic cell transplantation (HCT) can cure some chronic lymphocytic leukemia (CLL) subjects. This study compared outcomes of myeloablative (MA) and reduced-intensity conditioning (RIC) transplants from HLA-matched sibling donors (MSD) for CLL. From 1995 to 2007, information regarding 297 CLL subjects was reported to the Center of International Blood and Marrow Transplant Research; of these, 163 underwent MA and 134 underwent RIC MSD HCT. The MA subjects underwent transplantation less often after 2000 and less commonly received antithymocyte globulin (4% versus 13%, P= .004) or prior antibody therapy (14% versus 53%; P < .001). RIC was associated with a greater likelihood of platelet recovery and less grade 2 to 4 acute graft-versus-host disease compared with MA conditioning. One- and 5-year treatment-related mortality (TRM) were 24% (95% confidence intervals [CI], 16% to 33%) versus 37% (95% CI, 30% to 45%; P= .023), and 40% (95% CI, 29% to 51%) versus 54% (95% CI, 46% to 62%; P= .036), respectively, and the relapse/progression rates at 1 and 5years were 21% (95% CI, 14% to 29%) versus 10% (95% CI, 6% to 15%; P=020), and 35% (95% CI, 26% to 46%) versus 17% (95% CI, 12% to 24%; P= .003), respectively. MA conditioning was associated with better progression-free (PFS) (relative risk, .60; 95% CI, .37 to .97; P= .038) and 3-year survival in transplantations before 2001, but for subsequent years, RIC was associated with better PFS and survival (relative risk, 1.49 [95% CI, .92 to 2.42]; P= .10; and relative risk, 1.86 [95% CI, 1.11 to 3.13]; P=019). Pretransplantation disease status was the most important predictor of relapse (P= .003) and PFS (P= .0007) for both forms of transplantation conditioning. MA and RIC MSD transplantations are effective for CLL. Future strategies to decrease TRM and reduce relapses are warranted.
AB - Allogeneic hematopoietic cell transplantation (HCT) can cure some chronic lymphocytic leukemia (CLL) subjects. This study compared outcomes of myeloablative (MA) and reduced-intensity conditioning (RIC) transplants from HLA-matched sibling donors (MSD) for CLL. From 1995 to 2007, information regarding 297 CLL subjects was reported to the Center of International Blood and Marrow Transplant Research; of these, 163 underwent MA and 134 underwent RIC MSD HCT. The MA subjects underwent transplantation less often after 2000 and less commonly received antithymocyte globulin (4% versus 13%, P= .004) or prior antibody therapy (14% versus 53%; P < .001). RIC was associated with a greater likelihood of platelet recovery and less grade 2 to 4 acute graft-versus-host disease compared with MA conditioning. One- and 5-year treatment-related mortality (TRM) were 24% (95% confidence intervals [CI], 16% to 33%) versus 37% (95% CI, 30% to 45%; P= .023), and 40% (95% CI, 29% to 51%) versus 54% (95% CI, 46% to 62%; P= .036), respectively, and the relapse/progression rates at 1 and 5years were 21% (95% CI, 14% to 29%) versus 10% (95% CI, 6% to 15%; P=020), and 35% (95% CI, 26% to 46%) versus 17% (95% CI, 12% to 24%; P= .003), respectively. MA conditioning was associated with better progression-free (PFS) (relative risk, .60; 95% CI, .37 to .97; P= .038) and 3-year survival in transplantations before 2001, but for subsequent years, RIC was associated with better PFS and survival (relative risk, 1.49 [95% CI, .92 to 2.42]; P= .10; and relative risk, 1.86 [95% CI, 1.11 to 3.13]; P=019). Pretransplantation disease status was the most important predictor of relapse (P= .003) and PFS (P= .0007) for both forms of transplantation conditioning. MA and RIC MSD transplantations are effective for CLL. Future strategies to decrease TRM and reduce relapses are warranted.
UR - https://www.scopus.com/pages/publications/84905570108
UR - https://www.scopus.com/pages/publications/84905570108#tab=citedBy
U2 - 10.1016/j.bbmt.2014.05.020
DO - 10.1016/j.bbmt.2014.05.020
M3 - Article
C2 - 24880021
AN - SCOPUS:84905570108
SN - 1083-8791
VL - 20
SP - 1390
EP - 1398
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 9
ER -